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CONGRESS OF THE ESPU
17:01–17:04
S12-2 (PP)
BONE DENSITY AFTER ANAL DIVERSION
Nina HUCK
1
, Melanie WRUCK
2
, Simin SCHADMAND-FISCHER
3
, Johannes LOTZ
4
,
Patrick HONNECK
5
, Christian THOMAS
2
and Raimund STEIN
1
1) University Medical Centre Mannheim, Department of Pediatric and Adolescent Urology, Mannheim, GERMANY
- 2) Johannes Gutenberg University, Department of Urology, Mainz, GERMANY - 3) Johannes Gutenberg University,
Department of Radiology, Mainz, GERMANY - 4) Johannes Gutenberg University, Department of clinical Chemestry,
Mainz, GERMANY - 5) University Medical Centre Mannheim, Department of Urology, Mannheim, GERMANY
PURPOSE
The influence of the bone mineral content after urinary diversion is well known. Long-term results
after performing a continent anal diversion are rare in the literature. Also the definition of osteopo-
rosis as well as the methods to measure a bone density changed over the last 20 years. In this
long-term observational studies the bone density electrolytes and bone biochemical markers for an
increased bone turn over were measured
MATERIAL AND METHODS
37 patients with continent anal diversion were investigated with a median follow-up 23.6 years. For
measurement of the bone density mainly Dual-X-Ray-Absorptiometrie (DXA) was use. Blood gas
analysis, creatinine, electrolytes as well as beta-CrossLaps, Calcitonin, Osteocalcin, Prokollagen
Typ I Propeptid were measured
RESULTS
After a median of median follow-up of 17.5 years, a reduced bone mineral content could be observed
in 19/37 patients. In 4 patients, osteoporosis was diagnosed by DXA after a median follow-up of
39 years. Only one patient was treated with bisphosphonates for one year, the remaining patients
with Vitamin D. None of them developed any clinical signs. None of the biochemical makers could
predict a reduced bone mineral content or osteoporosis in this group of patient. None of the patients
had a severe acidosis.
CONCLUSIONS
Long-term follow-up of patients with a continent anal reservoir should include the measurement of
bone density and if there are signs of osteoporosis, treatment using Vitamin D should be started.